The Epigenetics Research Of The Occupational Stress And The Prevalence Of Hypertension In Medical Personnel Of Xinjiang

Objective: To investigate the correlation of polymorphisms of EMILIN1, SLC6A2 gene and the susceptibility of hypertension, as well as the occupational stress in affecting the mobidity of hypertension, the occupational stress levels, the physical and mental health status were taken in the medical personnel worked in hospitals of Xinjiang Province. By comparing the methylation of DNA on the promoter of NET gene under different levels of tense and blood pressure, to explore the regulation of epigenetics in occupational stress and hypertension, to complete the epidemiological data of occupational stress and health status of medical personnel in hospitals of Xinjiang province, to provide a scientific evidence for the development and improvement of the physical and mental health, as well as the prevention and treatment of hypertension of medical personnel. Methods: 1) 2036 medical personnel from hospitals in Xinjiang Province were cluster sampled in the study, job stress measurement scale(Job stress survey, JSS), job burnout and input questionnaires, the prevalence of chronic non-communicable diseases, as well as behavioral risk factors survey questionnaire were collected. 2) In a case-control study, polymerase chain reaction and restriction fragment length polymorphism method(polymerasechain reaction-restriction fragment length polymorphism, PCR-RFLP) was used to detect the gene polymorphism of 200 cases with diagnosed hypertension and 200 controls(matched gender, age�3years and ethnics). 3) DNA was processed by bisulfite-treated genomic clone sequencing, followed by PCR with designed BSP primers, PCR products were sequenced to determine whether CpG sites were methylated. Results: 1) Totally 2, 036 questionnaires were distributed and 1, 847 valid questionnaires were collected, the recovery rate was 90.7%. The occupational stress in all dimension for men are higher than female's(P<0.05). Different seniorities of occupational stress are different with each other(P<0.05). The seniority between 10 years to 20 years gets the highest occupational stress scores. were lower than 10-20 years group; seniority 10-20 years group dimensions of occupational stress scores were higher than>20years group(P<0.05). Different departments of occupational stress different dimensions scores(P<0.05). Surgery, obstetrics and gynecology group in addition to the intensity of work pressure and internal medicine, pediatrics group difference was not statistically significant, the rest of the dimensions of occupational stress scores were higher than internal medicine, pediatrics group; surgical, maternity group and internal medicine, pediatrics scores of each group of occupational stress They were higher than the medical technology group(P<0.05). In terms of different dimensions of occupational stress, the scores of occupational groups of different titles vary. The score of medium-grade professional title is the highest in occupational stress(P<0.05). The scores of surgery and gynaecology and obstetrics are both higher than that of internal medicine, pediatrics and medical technicians(P<0.05). In terms of total score in job burnout and emotional exhaustion; medical staff of different occupations score differently in job burnout, emotional exhaustion, deindividualization and reduction in sense of personal achievement(P<0.05). Regards to emotional exhaustion and reduction in sense of personal achievement, the high strain and medium strain groups are both greater than the low strain group(P<0.05). As to deindividualization, the high strain group scores the highest(P<0.05). Medical staff of different occupational stress levels obtain different scores in contribution(P < 0.05). With pairwise comparison of LSD, concerning contribution score, the scores of high stress and medium strain groups are both lower than the low stress group(P<0.05). Scores in different dimensions of occupational stress show positive correlations with job burnout total score and emotional exhaustion, and negative correlations with contribution(P<0.01). Job stress index, job pressure index and lack support index are positively correlated with deindividualization(P<0.05). 2) The survey of medical staff, slow disease patients among the top seven are: neck, waist disease(24.6%), chronic digestive diseases(21.5%), hypertension(14.9%), high cholesterol(10.1%), respiratory diseases(8.0%), chronic urinary system diseases(5.2%), thyroid disease(4.1%). Different groups of seniority neck, waist diseases, chronic digestive diseases, high blood pressure, high cholesterol prevalence increases with increasing length of service(P<0.05). Carotid different levels of occupational stress group, waist diseases, chronic digestive diseases, hypertension, hyperlipidemia prevalence of different(P<0.05). 3) The case group total cholesterol, fasting blood glucose were higher(P<0.05). Case and control groups in the genetic history of hypertension, passive smoking, salt, night frequency, quality of sleep, occupational stress levels, the difference was statistically significant(P<0.05). Occupational stress in case group were higher dimensions score(P<0.05). 4) rs2304682 locus genotypes and alleles in each case and control groups were statistically significant differences in distribution(P<0.05). rs2397771 allele in the case group and control group was statistically significant distribution difference(P<0.05). After adjusting the genetic history, passive smoking, salt, quality of sleep, night shift frequency, vocational impact stress levels to CC genotype rs2304682 locus as a reference, carrying GG genotype increased the risk of hypertension(OR=2.611, 95%CI: 1.190-5.727); with rs2304682 locus genotype CC+CG as a reference, carrying GG genotype increased the risk of hypertension(OR=2.432, 95%CI: 1.156-5.118). In rs2397771 GG genotype reference sites, carry the risk of hypertension increased GC genotype(OR=1.731, 95%CI: 1.057-2.835); GG genotype in rs2397771 locus as a reference to carry GC+CC genotype increased risk of hypertension(OR=1.703, 95%CI: 1.081-2.683). 5) The use of non-conditional Logistic regression analysis of gene-gene and gene-environment interactions found: rs2304682 and rs2397771, rs2304682 and occupational stress, rs2397771 and occupational stress model based on multiplying the interaction was not statistically significant(P>0.05). GMDR analysis using gene-gene and gene-environment interaction was found: rs2304682-rs2397771 model were statistically significant(P<0.05). Occupational stress-night shift frequency, rs2397771-occupational stress-night shift frequencies of the two models were statistically significant(P<0.001). Wherein rs2397771-occupational stress-night shift frequency model gene-environment interactions best model. 6) The medical staff of occupational stress-high blood pressure-hypertension associated gene suggest this investigation produce complex linkages among the various factors, occupational stress, gene polymorphisms and hypertension produce significant association between the presence of a strong, while living habits and other factors are indirect factors. 7) CpG1 and CpG7 between groups by analysis of variance, the difference was statistically significant(P<0.05). After LSD pairwise comparison, the control group-group of high occupational stress, hypertension-high occupational stress group methylation level is higher than the hypertension-low occupational stress group, the difference was statistically significant(P<0.05). Other CpG sites were not statistically significant. Conclusions: 1) Male medical personnel, seniority of 10-20 years group, and surgery, obstetrics and gynecology group demonstrated highest level of occupational stress and burnout. Middle-level medical stuff displayed highest occupational stress. Women showed higher score in the dimension of job input and dedication than female. Occupational stress was associated with individual characteristic of the medical stuff such as gender, seniority, departments and title. The higher occupational stress is correlated with higher level of job burnout, and the higher occupational stress resulted in less job input. Seniority and occupational stress might be the risk factors of the prevalence of chronic diseases in medical personnel. Chronic digestive diseases, hyperlipemia, occupational stress index, work stress index, emotional exhaustion and deindividualization are risk factors of hypertension in medical personnel. It recommends that hospitals should actively intervene to decrease the occupational stress and the risk of mental diseases of the work stuff, to strengthen the resources, to encourage self-care and self-cultivation, and to provide education on mental health regularly. 2) The genotype distribution of the SNP(single nucleotide polymorphism, SNP) sites in control population was in line with the frequencies of alleles in the Xinjiang Minority population, which proved less probability of biased distribution of genotype in the involved population due to sampling. There was genetic-environment interaction between two SNP sites(EMILIN1 gene rs2304682 and SLC6A2 gene rs2397771) and occupational stress, genetic history, passive smoking, salt, the quality of sleep and night shift frequency. Therefore, the individuals with genetic susceptibility should avoid external stimulating risk factors in order to prevent hypertension. Reduce the occupational stress and frequency of night shift of medical personnel resulted in reduced morbidity of hypertension; lifestyle might influence the polymorphisms of gene through the impact on occupational stress, and thus affected the prevalence of hypertension. It might provide effective interventions on the prevention of mental health problems and hypertension in medical stuff. 3) Compared the hypertension group and the control group with occupational stress, there was significant difference in the DNA methylation of GpG1 and GpG7 sites which located in the promoter region of NET gene, suggesting that epigenetic has a regulatory role in the correlation between occupational stress and hypertension.